I am an 49-year-old Asian female. Had endoscopic brow lift and upper/lower bleph done 10 months ago to correct droopy eyelids. My PS just told me that the brow lift has failed on the left side due to the extra strong muscle of my forehead. He offers to fix the problem with open procedure on the left lateral brow. I think both sides are failing but left side is worse. How common it is for endoscopic brow lift to fail? Typical reasons?
Brow lift failure?
Doctor Answers 6
Endoscopic Brow Lift vs Open Brow Lift
Although the idea of small incisions is appealing, there are numerous methods of "endoscopic/small incision forehead lifts" claiming adequate results -- and therefore many reasons why they might fail. The most reliable methods of achieving and maintaining long-term significant results from forehead lifts is to identify and excise redundant skin through longer incisions -- either with a coronal lift, hairline lift or mid-forehead lift.
Brow lift failure
endoscopic brow lifts are highly technique dependent and usually for the younger age group with relatively little droop that requires no skin excision. The open approach is time tested, reliable and long lasting. The sensory changes usually resolve in a year.
Endoscopic browlift failure.
Endoscopic browlift failure is caused by several factors. This can be corrected with the Irregular Trichophytic forehead lift on one or both sides. This was developed 35 years ago and is still my forehead lift of choice for most but not all patients.
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Brow lifts by any method can regress. The usual cause of failure is inadequate release of tissues at the orbital rim especially with a subperiosteal dissection as is done with the endoscopic brow lift. I prefer open procedures esoecially if there is a high hairline or there has been haurline elevation from an endoscopic browlift. The trichophytic hairline scar is rrarely detectible. However the open approach always has sensation changes in the scalp that go away with time.
Endoscopic Browl ifts are in general in less reliable.
Although I do perform endoscopic brow lifts, I only do so in select patients. In general I find open brow lifts are much more reliable both in terms of the longevity of the lift was well as the ability to address the forehead muscles. The fact that your surgeon want to correct the one side with an open procedure speaks to that fact. I think that the resulting scar is minimal and negligible if performed appropriately. The open approach allows for better release of the bone along the brow, direct visualization of the muscles and better fixation of the higher brow position. The results last for many years.
Endoscopic browlift failure
There are basically two ways for this procedure to fail. One is inadequate release of the tissues that pull the brows down, the other is inadequate fixation of the forehead in the elevated position. Get a second opinion from a second surgeon. It should not be a problem to redo the endoscopic forehead lift to avoid the scars of an open procedure.